Total Economic Impact

X.E.0

Lead Author(s):

Edward H. Yelin, PhD

Miriam Cisternas, MA

Supporting Author(s):

Sylvia I. Watkins-Castillo, PhD

Two factors affect the cost of treating musculoskeletal diseases in the United States. The first is the cost of medical services, which include inpatient and outpatient care, prescriptions, home health care, and a residual or “other” category including such items as medical devices. The second is the number of persons in this country with musculoskeletal disease conditions. Both will be explored in the associated web pages in this topic, and together, they will establish a baseline against which to assess future needs. It will be shown that both ongoing costs to treat these conditions and a high prevalence of musculoskeletal conditions in the aging population in relation to other medical conditions results in a huge, and growing, economic impact in the United States each year.

Edition:

2014

Cost to Treat Musculoskeletal Diseases

X.E.1

Lead Author(s):

Edward H. Yelin, PhD

Supporting Author(s):

Sylvia I. Watkins-Castillo, PhD

The mean direct cost per year per individual patient with a musculoskeletal disease has increased nearly 61% between the years 1996 to 1998 and 2009 to 2011, rising from just over $4,800 to nearly $7,800 per person in this time frame. Incremental costs, those cost most likely attributable to a musculoskeletal disease, rose from about $1,300 to $2,075. (Reference Table 10.4 PDF[1]CSV[2], Table 10.5 PDF [3]CSV[4])
At the same time, with the increasing number of individuals with musculoskeletal diseases in a growing and aging population, aggregate total direct cost to treat persons with a musculoskeletal disease between the years 1996 to 1998 and 2009 to 2011 increased by about 117%. For the years 2009 to 2011, the annual aggregate total direct cost, in 2011 dollars, is estimated to be $796.3 billion. Aggregate incremental medical cost is estimated to be $212.7 billion in 2009 to 2011, an increase of about 119% from the earlier time period. (Reference Table 10.6 PDF[5]CSV[6], Table 10.7 PDF[7]CSV[8])
Indirect total cost, as the difference in wages for persons age 18 to 64 years with a work history, and with and without musculoskeletal conditions, add another $77.5 billion to the aggregate cost for all persons with a musculoskeletal disease. Incremental indirect costs attributable to musculoskeletal disease alone are estimated to amount to $130.7 billion, indicating that wage losses attributable to musculoskeletal conditions are greater than the mean difference in wages between the two groups. Aggregate total indirect cost increased by 168% from the estimate in 1996 to 1998 to that of 2009 to 2011; aggregate incremental indirect costs rose by about 184%. (Reference Table 10.12 PDF[9]CSV[10])
Taking into account all costs for persons with a musculoskeletal disease, including other comorbid conditions, the total aggregate cost of treating these individuals, plus the cost to society in the form of decreased or lost wages (indirect cost), is estimated to be $873.8 billion per year. (Reference Table 10.14 PDF[11]CSV[12])

Edition:

2014

Share of GDP

X.E.2

Lead Author(s):

Edward H. Yelin, PhD

Miriam Cisternas, MA

Supporting Author(s):

Sylvia I. Watkins-Castillo, PhD

Between the years 1996 to 1998 and 2009 to 2011, the Gross Domestic Product (GDP), in constant 2011 dollars, has risen from $11.5 trillion to $15.2 trillion, an increase of 32%.1 Over the same two time frames, total direct and indirect costs of musculoskeletal conditions rose from $396.1 billion to $873.8 billion. This is an increase of 121%, or nearly four times the rate of increase as the GDP.
As a share of GDP, using the same 2011 dollars base, total direct and indirect costs for musculoskeletal conditions increased by 67%, from 3.43% to 5.73%. Indirect costs saw a sharper rate of increase of slightly more than 100%. However, indirect cost are a much smaller share of total cost than direct costs, constituting 0.25% of GDP in 1996 to 1998 and 0.51% in 2009 to 2011. Direct costs rose from a 3.18% share to a 5.22% share over the same time period. (Reference Table 10.14 PDF[11]CSV[12])
To provide a basis for comparison, the economy is said to be in a recession when GDP declines by at least 1% for two or more consecutive quarters. Accordingly, the aggregate economic impact of the medical expenditures attributable to persons with musculoskeletal diseases is far in excess of the amount used to define a recession and, unlike a recession, occurs in perpetuity.